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Objective To provide better preconceptional and prenatal counseling to patients with Sjögren syndrome (SS). Methods In total, 2,100 143 pregnancies between 2004 and 2014 were identified in the Taiwan National Health Insurance database and birth registry. The maternal history of SS was ascertained, and data were compared between pregnant women with and without SS. We assessed the odds ratios and 95% confidence intervals of fetal–neonatal and maternal outcomes. Results There were 449 pregnancies in women with SS and 2,099 694 pregnancies in women without SS. Regarding fetal outcomes, the risks of still birth (odds ratio [OR] = 2.14, 95% confidence interval [CI] = 1.01–4.55), low birth weight (<2500 g, OR = 2.53, 95% CI = 1.92–3.33), small for gestational age (OR = 2.03, 95% CI = 1.57–2.03), and fetal distress (OR = 1.72, 95% CI = 1.2–2.45) as well as risks of pulmonary oedema (OR = 11.64, 95% CI = 1.62–83.48), shock (OR = 6.07, 95% CI = 1.51–24.3), and respiratory distress (OR = 5.61, 95% CI = 1.39–22.6) were higher in the SS group than in the non-SS group. Conclusion Women with SS have significant risks of adverse fetal–neonatal and maternal outcomes and must undergo prenatal counseling to understand the risks involved before conception.

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